[1]朱志远,王海燕,吴 波,等.冠心病患者血小板和淋巴细胞比值与冠脉斑块稳定性及预后的相关性[J].现代检验医学杂志,2019,34(04):112-115.[doi:10.3969/j.issn.1671-7414.2019.04.027]
 ZHU Zhi-yuan,WANG Hai-yan,WU Bo,et al.Correlation between Ratio of Platelet to Lymphocyte with the Stability of Coronary Artery Plaque and Prognosis in Patients with Coronary Heart Disease[J].Journal of Modern Laboratory Medicine,2019,34(04):112-115.[doi:10.3969/j.issn.1671-7414.2019.04.027]
点击复制

冠心病患者血小板和淋巴细胞比值与冠脉斑块稳定性及预后的相关性()
分享到:

《现代检验医学杂志》[ISSN:/CN:]

卷:
第34卷
期数:
2019年04期
页码:
112-115
栏目:
论著
出版日期:
2019-08-20

文章信息/Info

Title:
Correlation between Ratio of Platelet to Lymphocyte with the Stability of Coronary Artery Plaque and Prognosis in Patients with Coronary Heart Disease
文章编号:
1671-7414(2019)04-112-05
作者:
朱志远王海燕吴 波王宏宝李 微白旭东任燕妮何雪琴周 坛戴 军
(同济大学附属杨浦医院安图分院心内科,上海 200093)
Author(s):
ZHU Zhi-yuanWANG Hai-yanWU BoWANG Hong-baoLIWeiBAI Xu-dongREN Yan-ni HE Xue-qinZHOU TanDAI Jun
(Department of Cardiology, Antu Branch,Yangpu Hospital of Tongji University,Shanghai 200093,China)
关键词:
血小板与淋巴细胞比值 冠心病 冠脉斑块稳定性 预后
分类号:
R541.4; R446.11
DOI:
10.3969/j.issn.1671-7414.2019.04.027
文献标志码:
A
摘要:
目的 研究冠心病(coronary heart disease,CHD)患者血小板与淋巴细胞比值(platelet lymphocyte ratio,PLR)对冠脉斑块稳定性和预后的影响。方法 测定62例CHD患者(CHD组)及30例健康体检者(对照组)的血细胞检测和血糖、血压、血脂、肝肾功等生化指标。根据斑块性质分为易损斑块组(n=35)和稳定斑块组(n=27); 根据入院时PLR值分为低PLR组(n=30)和高PLR组(n=32)。比较各组临床指标,分析PLR对CHD患者斑块稳定性和预后的影响。结果 各组高血压病史(0,40.74%,48.57%),糖尿病病史(0,18.52%,42.86%),CRP(8.54±1.57,9.39±1.84,10.70±2.56)mg/L,Scr(50.84±10.87,61.27±13.16,75.18±15.54)μmol/L,BUN(5.37±0.50,6.91±1.17,8.48±2.05)mmol/L,FIB(2.76±0.39,3.14±0.54,3.36±0.66)g/L,PLT(181.43±43.48,229.26±50.87,238.47±47.93)×109/L,LYM(2.23±0.65,1.86±0.62,1.80±0.77)×109/L和PLR(95.75±24.72,112.43±24.48,131.83±26.81)比较,差异均有统计学意义(tχ2为3.4662.96,P<0.05)。多因素logistics回归分析显示,CRP(OR=2.29,95CI%:1.78~2.74),FIB(OR=2.03,95CI%:1.18~2.86)和PLR(OR=3.25,95CI%:1.88~4.61)均是CHD患者冠脉斑块不稳定的独立危险因素(P=0.007,0.004,0.000)。CRP,FIB和PLR联合预测CHD患者冠脉斑块稳定性的敏感度、特异度分别为83.1%和81.9%,均显著高于三个指标单独评估的敏感度、特异度(P<0.05)。高PLR组不良心血管事件(MACE)的发生率47.0%,显著高于低PLR组(20.00%),差异有统计学意义(χ2=4.09,P=0.043)。结论 PLR是CHD患者冠脉斑块稳定性的独立危险因素,且与预后密切相关,有助于指导临床决策。
Abstract:
Objective To explore the effects of platelet-lymphocyte ratio(PLR)on the stability of coronary artery plaque and prognosis in patients with coronary heart disease(CHD).Methods Blood routine,blood glucose,blood pressure,blood lipids,liver and kidney function were determined in 62 CHD patients(CHD group)and 30 healthy subjects(control group).According to the nature of plaque,patients were divided into vulnerable plaque group(n=35)and stable plaque group(n=27).According to thePLR value on admission,patients were divided into low PLR group(n=30)andhigh PLR group(n=32).Clinical indicators of each group were compared,andthe influence of PLR on plaque stability and prognosis of CHD patients was analyzed.Results There was significant difference on historyof diabetes(0,40.74%,48.57%)and hypertension(0,18.52%,42.86%),CRP(8.54±1.57,9.39±1.84,10.70±2.56)mg/L,Scr(50.84±10.87,61.27±13.16,75.18±15.54)μmol/L,BUN(5.37±0.50,6.91±1.17,8.48±2.05)mmol/L,FIB(2.76±0.39,3.14±0.54,3.36±0.66)g/L,PLT(181.43±43.48,229.26±50.87,238.47±47.93)×109/L,LYM(2.23±0.65,1.86±0.62,1.80±0.77)×109/L and PLR(95.75±24.72,112.43±24.48,131.83±26.81),among each group(t/χ2=3.46~62.96,all P<0.05).Multiple logisticsregression analysis showed that CRP(OR=2.29,95CI%:1.78~2.74),FIB(OR=2.03,95CI%:1.18~2.86)and PLR(OR=3.25,95CI%:1.88~4.61)were independentrisk factors for coronary plaque instability in CHD patients(P=0.007,0.004,0.000).The sensitivity and specificity of combined detection of CRP,FIB and PLR to predict the stability of coronary artery plaque were 83.1% and 81.9%,respectively,which were significantly higher than separate detection(P<0.05).Theincidence of MACE in high PLR group was 47.0%,significantly higher than 20.00% in low PLR group(χ2=4.09,P=0.043),respectively.Conclusion PLR is independent risk factors for stability of coronary artery plaque in CHD patients,and closely related to the prognosis,it helps to guide the clinical decision.

参考文献/References:

[1] PIETRUSZYNSKI R,MARKUSZEWSKI L,MASI-AREK K,et al.Role of preprocedural glutathione concentrations in the prediction of major adverse cardiacevents in patients with acute coronary syndrome treated with percutaneous coronary intervention[J].Polskie Archiwum Medycyny Wewnetrzne,2013,123(5):228-237. [2] AKBAS EM,DEMIRTAS L,OZCICEK A,et al.Association of epicardial adipose tissue,neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio with diabetic nephropathy[J].Int J Clin Exp Med,2014,7(7):1794-1801. [3] YUKSEL M,YILDIZ A,OYLUMLU M,et al.The association between platelet/lymphocyte ratio and coronary artery disease severity[J].The Anatolian Journalof Cardiology,2015,15(8):640-647. [4] YODYING H,MATSUDA A,MIYASHITA M,et al.Prognostic significance of neutrophil-to-lymphocyte ratio and platelet-to- lymphocyte ratio in oncologic outcomes of esophageal cancer:asystematic review and neta-analysis[J].Annals of Surgical Oncology,2016,23(2):646-654. [5] 屠春平,蔡云祥,邢铭芬,等.NLR和PLR对胸痛的冠心病患者心肌肌钙蛋白Ⅰ升高的预测价值[J].医学研究杂志,2015,44(6):145-147. TU Chunping,CAI Yunxiang,XING Mingfen,et al.Predictire value ofneutrophil and platelet-lymphocyte on increasing cardiac troponin I in chest pain patients with coronary artery disease[J].Journal of Medical Research,2015,44(6):145-147. [6] 葛均波,徐永健.内科学[M].8版.北京:人民卫生出版社,2013:227-255. GE Junbo,XU Yongjian.Internal medicine[M].8th Ed.Beijing:People's Medical Publishing House,2013:227-255. [7] MINTZ G S,NISSEN S E,ANDERSON W D,et al.American college of cardiology clinical expert consensus document on standards for acquisition,measurementand reporting of intravascular ultrasound studies(IVUS).A report of the American college of cardiology task force on clinical expertconsensus documents[J].J Am Coil Cardiol,2001,37(4):1478-1492. [8] OEMRAWSINGH R M, CHENG J M, GARCIA-GARCIA H M,et al.High-sensitivity troponin T in relation to coronary plaque characteristics in patients with stable coronary artery disease; results of the ATHEROREMO-IVUS study[J].Atherosclerosis,2016,247:135-141. [9] BROWN A J,SHAH A S,WEST N E,et al.High-sensitivity troponin I is associated with high-risk plaque and MACE in stable coronary artery disease[J].JACC Cardiovascular Imaging,2017,10(10PtA):1200-1203. [10] MARIANI L,BURZOTTA F,AURIGEMMA C,et al.Frequency-domain optical coherence tomography plaque morphology in stable coronary artery disease:sex differences[J].Coron Artery Dis,2017,28(6):472-477. [11] ANDO K,TAKAHASHI H,WATANABE T,et al.Impact of serum uric acid levelson coronary plaque stability evaluated using integrated backscatter intravascular ultrasound in patients with coronary artery disease[J].Journal of Atherosclerosis & Thrombosis,2016,23(8):932-939. [12] AKBAS E M,DEMIRTAS L,OZCICEK A,et al.Association of epicardial adipose tissue,neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio with diabetic nephropathy[J].Int J Clin Exp Med,2014,7(7):1794-1801. [13] YUE Song,ZHANG Jiahua,WU Jingyang,et al.Use of the monocyte-to-lymphocyte ratio to predict diabetic retinopathy[J].International Journal of Environmental Research & Public Health,2015,12(8):10009-10019. [14] ZHANG Weiwei,LIU Kejun,HU Guolin,et al.Preoperative platelet/lymphocyte ratio is a superior prognostic factor compared to other systemic inflammatory response markers in ovarian cancer patients[J].Tumor Biology,2015,36(11):8831-8837. [15] HUDZIK B,SZKODZINSKI J,KORZONEK-SZLACHETA I,et al.Platelet-to-lymphocyte ratio predicts contrast-induced acute kidney injury in diabetic patients with ST-elevation myocardial infarction[J].Biomarkers in Medicine,2017,11(10):847-856. [16] ZHOU Xin,DU Yiping,HUANG Zebo,et al.Prognostic value of PLR in various cancers:a meta-analysis[J].PLoS One,2014,9(6):e101119. [17] 李春光,黄宇玲,刘杰,等.纤维蛋白原及同型半胱氨酸与冠状动脉易损斑块的相关性[J].当代医学,2018,24(34):6-9. LI Chunguang,HUANG Yuling,LIU Jie,et al.The correlation of fibrinogenand homocysteine with vulnerable coronary atherosclerotic plaques[J].Contemporary Medicine,2018,24(34):6-9. [18] 孟新颜,杨承志.内正五聚蛋白3和血小板与淋巴细胞比值对急性脑梗死患者颈动脉粥样硬化斑块稳定性和近期预后的影响研究[J].实用心脑肺血管病杂志,2018,26(9):29-32. MENG Xinyan,YANG Chengzhi.Impact of PTX3 and PLR on stability of carotidatherosclerostic plaques and short-term prognosis in patients with acute cerebral infarction[J].Practical Journal of Cardiac Cerebral Pneumal and VascularDisease,2018,26(9):29-32. [19] AYCA B,AKIN F,CELIK O,et al.Platelet to lymphocyte ratio as a prognostic marker in primary percutaneous coronary intervention[J].Platelets,2015,26(7):638-644. [20] UAR,F M,ACAR B,GUI M,et al.The association between platelet/lymphocyte ratio and coronary artery disease severity in asymptomatic low ejection fraction patients[J].Korean Circulation Journal,2016,46(6):821-826.

相似文献/References:

[1]赵 佳a,左 林b,姚创利a,等.锰超氧化物歧化酶基因变异 与血脂和同型半胱氨酸水平的关系研究[J].现代检验医学杂志,2016,31(03):12.[doi:10.3969/j.issn.1671-7414.2016.03.004]
 ZHAO Jiaa,ZUO Linb,YAO Chuang-lia,et al.Study on the Relationship between Manganese Superoxide Dismutase Gene Variants and the Levels of Blood Lipid and Homocysteine[J].Journal of Modern Laboratory Medicine,2016,31(04):12.[doi:10.3969/j.issn.1671-7414.2016.03.004]
[2]程俊杰,李 静,梁西强,等.非高密度脂蛋白胆固醇 与冠心病患者心功能分级的相关性研究[J].现代检验医学杂志,2016,31(03):43.[doi:10.3969/j.issn.1671-7414.2016.03.012]
 CHENG Jun-jie,LI Jing,LIANG Xi-qiang,et al.Correlation between Non High Density Lipoprotein Cholesterol and Cardiac Function in Patients with Coronary Heart Disease[J].Journal of Modern Laboratory Medicine,2016,31(04):43.[doi:10.3969/j.issn.1671-7414.2016.03.012]
[3]张阳东a,陈 洁b,楚瑞雪,等.冠心病患者α-内收蛋白基因多态性与表达水平研究[J].现代检验医学杂志,2016,31(03):59.[doi:10.3969/j.issn.1671-7414.2016.03.016]
 ZHANG Yang-donga,CHEN Jieb,CHU Rui-xue,et al.Study on Polymorphisms and Genes Expression Levels of α-Adducin in Patients with Coronary Artery Disease[J].Journal of Modern Laboratory Medicine,2016,31(04):59.[doi:10.3969/j.issn.1671-7414.2016.03.016]
[4]刘运端,林世恒.脂联素及其基因多态性与广西瑶族冠心病的关系[J].现代检验医学杂志,2015,30(04):56.[doi:10.3969/j.issn.1671-7414.2015.04.015]
 LIU Yun-duan,LIN Shi-heng.Study on Relations between Adiponectin and Its Gene Polymorphism and Yao Coronary Heart Disease of Guangxi District[J].Journal of Modern Laboratory Medicine,2015,30(04):56.[doi:10.3969/j.issn.1671-7414.2015.04.015]
[5]姚创利a,赵 佳a,黎 阳a,等.锰超氧化物歧化酶9 Ala/Val基因多态性对冠心病的影响[J].现代检验医学杂志,2015,30(02):1.[doi:10.3969/j.issn.1671-7414.2015.02.001]
 YAO Chuang-lia,ZHAO Jiaa,LI Yanga,et al.Effects of Manganese Superoxide Dismutase 9 Ala/Val Genetic Polymorphisms on Coronary Heart Disease[J].Journal of Modern Laboratory Medicine,2015,30(04):1.[doi:10.3969/j.issn.1671-7414.2015.02.001]
[6]姚创利,赵 佳,鲁旭娟,等.冠心病患者血清脂蛋白相关磷脂酶A2水平与锰超氧化物歧化酶9 Ala/Val基因多态性关系探讨[J].现代检验医学杂志,2017,32(01):26.[doi:10.3969/j.issn.1671-7414.2017.01.008]
 YAO Chuang-li,ZHAO Ja,LU Xu-juan,et al.Study on the Relationship between Lipoprotein Associated Phospholipase A2 Level and Manganese Superoxide Dismutase 9 Ala/Val Genetic Polymorphism in Patients with Coronary Heart Disease[J].Journal of Modern Laboratory Medicine,2017,32(04):26.[doi:10.3969/j.issn.1671-7414.2017.01.008]
[7]张阳东,周建荣,楚瑞雪,等.血管紧张素Ⅱ1型受体3个单核苷酸多态性与冠心病的相关性分析[J].现代检验医学杂志,2017,32(02):57.[doi:10.3969/j.issn.1671-7414.2017.02.015]
 ZHANG Yang-dong,ZHOU Jian-rong,CHU Rui-xue,et al.Correlation between the Three Single Nucleotide Polymorphisms in Angiotensin Ⅱ Type one Receptor Gene and Coronary Artery Disease[J].Journal of Modern Laboratory Medicine,2017,32(04):57.[doi:10.3969/j.issn.1671-7414.2017.02.015]
[8]刘夏炎,余安运,于佩方,等.RDW,HCY和LP(a在高血压及冠心病中的临床应用[J].现代检验医学杂志,2017,32(04):80.[doi:10.3969/j.issn.1671-7414.2017.04.022]
 LIU Xia-yan,YU An-yun,YU Pei-fang,et al.Clinical Application of RDW,HCY and LP(a)in High Blood Pressure and Combined Coronary Heart Disease[J].Journal of Modern Laboratory Medicine,2017,32(04):80.[doi:10.3969/j.issn.1671-7414.2017.04.022]
[9]阿地拉·阿布里孜,刘 敏.miR-126在血液透析并发冠心病患者中检测的临床意义[J].现代检验医学杂志,2017,32(05):97.[doi:10.3969/j.issn.1671-7414.2017.05.017]
 ADILA·Abulizi,LIU Min.Clinical Significance of Detecting miR-126 in Hemodialysis with Coronary Artery Disease[J].Journal of Modern Laboratory Medicine,2017,32(04):97.[doi:10.3969/j.issn.1671-7414.2017.05.017]
[10]邝美华,陈意珊,石亚玲.血小板与淋巴细胞比值对非小细胞肺癌预后评估的Meta分析[J].现代检验医学杂志,2018,33(03):112.[doi:10.3969/j.issn.1671-7414.2018.03.028]
 KUANG Mei-hua,CHEN Yi-shan,SHI Ya-ling.Prognostic Value of Platelet to Lymphocyte Ratio in Non-Small Cell Lung Cancer:a Meta-analysis[J].Journal of Modern Laboratory Medicine,2018,33(04):112.[doi:10.3969/j.issn.1671-7414.2018.03.028]

备注/Memo

备注/Memo:
作者简介:朱志远(1964-),男,本科,主治医师,研究方向:冠心病,心力衰竭,E-mail:zhuzyuan1964@sina.com。收稿日期:2019-04-03 修回日期:2019-04-28
更新日期/Last Update: 2019-07-30